patch.com - Carfentanil: What You Should Know About The Deadly New Opioid In NJ

Just when things seemed like they couldn’t get any worse on the opioid front, the drug culture in New Jersey took a gargantuan step backward in 2017 with the popularization and distribution of a substance so deadly that first responders need to wear protective equipment before handling it.

Carfentanil, which until this spring had only been widespread as close as western Pennsylvania, has been responsible for several overdoses and arrests in the Philadelphia area over the past several months. Officials in New Jersey have warned of the presence of the drug in the state.

Here’s what you need to know about the lethal drug diffusing through the streets of the Garden State.

Genesis

Carfentanil was designed in 1974 by Janssen Pharmaceutica, according to the Pennsylvania Department of Health. Janssen is owned by Johnson and Johnson.

Marketed for veterinary and zoological use under the name Wildnil, its purpose is as a tranquilizer to control very large animals, including elephants. However, in recent years it has begun showing up on the streets, being put to a very different purpose.

Authorities believe the drug to be 10,000 times deadlier than street-level heroin and 100 times deadlier than the already lethal fentanyl.

The equivalent of roughly one grain of salt of carfentanil is enough to kill a human. In 2016, the U.S. Drug Enforcement Administration produced a graphic showing what a deadly amount of two milligrams of carfentanil looks like next to a penny. The lethal powder barely covers President Lincoln’s cheek.

Obviously, individuals who ingest carfentanil in any way are at immediate risk of a lethal overdose. However, first responders are also at severe risk.There is growing evidence that suggests even touching the substance can cause damage.

Symptoms of include respiratory depression or arrest, drowsiness, disorientation, sedation, pinpoint pupils and clammy skin, according to health officials. Symptoms typically occur just minutes after exposure.

The drug has never been approved for use on humans in any form.

Gray Death

Taking on the street name “gray death,” widespread carfentanil overdoses first hit the United States in the summer of 2016.

A 2016 Associated Press investigative report revealed that the drug has potential terrorist implications and is primarily manufactured in China.

“Carfentanil is surfacing in more and more communities,” then-DEA Acting Administrator Chuck Rosenberg said at the time. “We see it on the streets, often disguised as heroin. It is crazy dangerous.”

There have been hundreds of fatal carfentanil overdoses across the U.S. over the last year, mostly in the Midwest, though the the drug began appearing in new areas in early 2017.

The drug is dispensed in a wide variety of forms, ranging from powder, blotter paper, tablets, patches, and sprays, according to the Pennsylvania Department of Health.

Arrival in New Jersey

While heroin and the even deadlier fentanyl ravaged New Jersey, there was no sign of carfentanil nearby until recently. Health officials said that they had been tracking carfentanil in western Pennsylvania for some time, but that the drug only began to spread in a significant way east of Harrisburg this spring.

Calling the growing threat "extremely dangerous," Pennsylvania Gov. Tom Wolf announced on Sept. 29, 2016 the temporary transition of carfentanil to a schedule II controlled substance in the state, giving law enforcement there more leverage in fighting the spread of the drug.

Around that time, municipalities around the state began offering additional training programs for first responders on how to handle dangerous opioids like carfentanil, and how to administer Narcan, which can reverse overdoses.

The drug's first fatality in eastern Pennsylvania struck in Dec. 2016, when a 59-year-old Philadelphia man was killed. There were two more overdoses in the city in June of 2017, in addition to deaths in Montgomery and Chester counties and the hospitalization of four first responders in Bucks County.

No deaths due to carfentanil have yet been reported in New Jersey.

Cause of Increase in Overdoses

While officials cannot say exactly what has caused the sudden popularity of the drug, there are many theories. For one, addicts are often not looking for carfentanil just as they are not looking for fentanyl; they want heroin, and then buy a substance which they are told is just a stronger dose or a new strain of it. In reality it turns out to be carfentanil, disguised as heroin.

"Fentanyl and its analogues are often mixed with heroin both with and without the user's knowledge," the Philadelphia Department of Public Health said in their July health alert.

A district attorney in Middlesex, Massachussetts, Marian Ryan, said there is also growing trend showing cocaine is becoming more popular nationally because it can be cut with opoids like fentanyl - and carfentanil.

War on Opioids

The CDC estimates that 89 people die every day from an opioid-related overdose in the U.S.

Carfentanil joins heroin and fentanyl in the ongoing war on opioids in New Jersey and across the nation.

Ocean County prosecutor Al Della Fave said in January opioid crisis has become so severe in New Jersey that "we have running statewide alerts 365 days a year," and carfentanil easily falls into that group. He said the number of opioid-related deaths in Ocean County alone nearly doubled in 2016, jumping to 197 from 118 in 2015.

In January, Gov. Chris Christie signed Executive Order 219 declaring the opioid epidemic a public health crisis in New Jersey. The action requires the marshaling of all appropriate resources to combat its harmful effects on state citizens.

“We must take aggressive action to get this insidious crisis under control so I am calling together all resources of state government in order to save lives,” said Christie. “The human cost of this epidemic is incalculable, impacting every part of life in New Jersey, affecting our education system, our health care system, public safety and the financial security of every person it touches.”

State and regional leaders continue looking at new ways to battle the epidemic. The New Jersey Division of Consumer Affairs, in partnership with the NJ Attorney General, announced a series of initiatives in May. Among their efforts: